Q: Why is my child experiencing a returning fever and severe cough after being discharged from the hospital for RSV and Rhinovirus?

Medically reviewed by Sang Hyun Ahn, MD

Content edited by Myeongchan Kim, MD

This post is a dramatization of a question and answer session experienced by our actual medical reviewers. Please note that this content is for informational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional for any health concerns or before making any decisions related to your health or treatment.

Question:

My child recently had a high fever and was diagnosed with laryngitis and bronchiolitis. Blood tests showed high inflammation markers, and they tested positive for both RSV and Rhinovirus, which led to a hospital admission. The fever went down by the second day of hospitalization, and the airway swelling improved, so we were discharged a few days later with oral medications.

However, after coming home, the fever returned. I've had to give fever reducers about twice a day because the fever drops and then rises again. Since last night, a constant low-grade fever (37.4–37.8°C) has persisted. We are strictly following the medication schedule, using the nebulizer, and applying cough patches, but the cough remains severe.

Since my child maintained a normal temperature in the hospital, is the returning fever happening because the original viruses aren't completely gone yet, or could this be a new viral infection that requires another test?

Answer:

Hello! It is completely understandable that you are worried about the fever returning after your child's hospitalization for RSV and Rhinovirus.

It is actually quite common for a fever to return after discharge. Co-infections with RSV and Rhinovirus, in particular, tend to have a prolonged recovery period.

Here is an assessment of your child's current situation:

• A temperature of 37.4–37.8°C is considered a low-grade fever, which indicates that the original viruses have not completely cleared from the body yet.

• During hospitalization, medications such as steroids or other intensive treatments may have temporarily suppressed the fever, which can reappear once those treatments are reduced or stopped upon discharge.

• RSV is known for causing symptoms that can linger for up to 2 to 3 weeks.

Here is what you can do at home right now:

1. Continue current treatments: Keep using the prescribed oral medications and the nebulizer as directed.

2. Hydration: Ensure your child drinks plenty of fluids. Warm water is excellent (honey water can be given if the child is over 1 year old).

3. Humidification: Use a humidifier in the room to help soothe the severe cough and keep the airways moist.

4. Fever reducers: Only administer antipyretics if the fever reaches 38.5°C or higher, or if your child is visibly uncomfortable or in pain.

When to seek immediate medical attention:

• The fever spikes to 39°C or higher.

• Your child’s breathing becomes rapid, or they show signs of struggling to breathe.

• Their food or fluid intake drops to less than half of their usual amount.

• They have not produced any urine for 8 hours or more.

At this stage, it is highly likely that this is part of the natural recovery process from the existing infection, rather than a brand-new virus. However, if your child's symptoms worsen at any point, or if there is no improvement after 3 to 4 days, please follow up with your pediatrician for an in-person evaluation.

For extra peace of mind and clear guidance when tracking your child's symptoms, the FeverCoach app is always there to help.

fevercoach.us

Apple App Store

Google Play

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